M. Ciesielczyk

Tissue Doppler echocardiographic identification of ischemic etiology in patients with dilated cardiomyopathy.

Objective. To compare the left ventricular function in patients with ischemic and nonischemic cardiomyopathy using tissue Doppler echocardiography (TDE). Methods. We studied 30 patients after myocardial infarction (MI group), 30 patients with dilated cardiomyopathy (DCM group) and 60 healthy volunteers in corresponding control groups. TDE velocities, time intervals of cardiac cycle were measured and dispersion index of TDE parameters was calculated. Results. Early diastolic velocities were lower in MI group than in DCM group, with similar systolic and late diastolic velocities. The dispersion index of systolic velocities was significantly higher in MI than in DCM group and in controls (respectively 33.1±6.0% vs 12.6±3.7% vs 15.9±5.6%; p < 0.001) and differentiated ischemic from idiopathic dilated cardiomyopathy. In MI group, preejection period was shorter and isovolumic relaxation and diastasis time were longer than in DCM group, with no differences in dispersion index of time intervals between the groups. Conclusions. TDE parameters: early diastolic velocity, preejection period, isovolumic relaxation time and the dispersion index of systolic velocities differentiate ischemic and nonischemic etiology of dilated cardiomyopathy.

752 Aortic wall thickness and pulsatility - do they represent the same aspect of atherosclerosis?

diastole. Study group consisted of 38 consecutive patients referred for the routine TEE. Thoracic aorta was scanned by rotational 3-D TEE. Reformatted datasets were reviewed and the lumen-intima and media-adventitia interfaces were determined. Serial volumetric calculations of 2 cm segments at three levels of the thoracic aorta were performed. The volume of lumen of two-centimeter segments measured at three levels of the thoracic aorta (30 cm, 35 cm and 40 cm from incisors) varied from 7.3 to 17.6 cm 3 (mean 12.0±3.2, 11.5±3.1 and 10.9±2.5 cm3 respectively). The volume of intimamedia complex varied from 0.5 to 5.0 cm 3 (mean 1.8±1.0, 1.6±1.0 and 1.7±1.1 cm3 respectively). Aortic pulsation defined as the difference between the largest and the smallest lumen volume of the same aortic segment varied from 0.0 to 2.8 cm3 (mean 1.3±0.5, 1.1±0.7 and 1.1±0.6 cm3 respectively). The intima-media complex volume was correlated with the aortic lumen volume (R2=0.55, p<0.001), but not with the aortic pulsation (R2=0.02, p=NS). The differences in the measurements of aortic lumen volume, aortic pulsation and intima-media complex volume by the same observer were 0.22±0.10 cm3, 0.07±0.08 cm3 and 0.21±0.06 cm3 respectively, whereas by two observers 0.23±0.15 cm3 ,0 .14 ±0.13 cm3 and 0.17±0.03 cm3 respectively. Following risk factors were independently related to the intima-media complex volume: hypertension (p<0.001), hyperlipidemia (p=0.032) and cigarette smoking (p=0.045). Age (p<0.001), diabetes (p=0.002), masculine gender (p=0.014) and family history (p=0.014) were related to the aortic pulsation. Conclusions: Aortic intima-media complex volume and aortic pulsation represent different aspects of aortic properties and are related to different clinical risk factors of atherosclerosis.